Abstract Purpose To compare proprietary (GPT-4o, Gemini 1.5 Pro) and open-source (Llama 3.1 70B, Llama 3.1 405B) large language models (LLMs) for extracting clinically relevant variables from transarterial chemoembolization (TACE) reports in patients with hepatocellular carcinoma (HCC). Methods Retrospective analysis of 556 anonymized longitudinal TACE-related reports (radiology, interventional procedure, and clinical follow-up) from 50 patients with HCC treated between 2012 and 2024 at a single tertiary center was carried out. Models extracted predefined binary variables (e.g., modified Response Evaluation Criteria in Solid Tumors [mRECIST] tumor response, alpha-fetoprotein [AFP] dynamics, Barcelona Clinic Liver Cancer [BCLC] stage) and ordinal variables (e.g., liver segment involvement, vascular invasion, follow-up assessment) using a standardized system prompt and output template. Model performance was assessed by accuracy, ordinal scores, and longitudinal error rates using mixed-effects regression with patient-level random intercepts. Results Proprietary models outperformed open-source models. GPT-4o and Gemini achieved the highest mean accuracies for binary variables (0.87 ± 0.21 and 0.85 ± 0.16) and ordinal variables (4.15/5 and 4.10/5), significantly exceeding both Llama models ( p < 0.05). GPT-4o showed the lowest longitudinal error rate for binary variables (0.01 vs 0.09–0.21 for the other models), indicating greater robustness over time. All models showed poor performance in vascular invasion detection and follow-up assessment. Conclusion Proprietary LLMs can accurately extract most key TACE-related variables from routine clinical reports and may support decision-making in interventional oncology; however, all models showed poor performance in vascular invasion detection and follow-up assessment, so expert human oversight remains essential. Graphical abstract

Mass Spectrometry Imaging Applications for Advancement of Interventional Oncology.

ABSTRACTBackgroundPost‐embolization syndrome after transarterial chemoembolization (TACE) and Yttrium‐90 radioembolization (TARE) causes significant morbidity. Understanding whether discharge prescriptions influence short‐term outcomes may guide standardized pain‐management strategies.MethodsA retrospective cohort study of 3191 patients (3988 procedures) with hepatocellular carcinoma from the Merative MarketScan Databases (2009–2022) was performed. The composite outcome was 7‐day drug escalation or hospital readmission. Bivariate logistic regression identified candidate variables (p < 0.10); multivariable logistic regression with patient‐clustered robust standard errors estimated adjusted odds ratios (aORs), adjusting for age, sex, and Charlson Comorbidity Index (CCI).ResultsCompared to patients discharged without opioids post‐chemoembolization, those prescribed opioids at discharge had 83% lower odds of experiencing drug escalation or readmission (odds ratio [aOR] = 0.17, p < 0.001), and those undergoing radioembolization had 59% lower odds (aOR = 0.41, p < 0.001). Being prescribed antiemetics or steroids was also associated with lower odds of escalation/readmission events, with percentages varying by procedure type.ConclusionsPrescribing opioids, along with antiemetics and steroids, at discharge may reduce the likelihood of post‐procedural events, such as drug escalation and readmission, in patients undergoing trans‐arterial chemoembolization and radioembolization for hepatocellular carcinoma. These findings highlight the importance of a comprehensive pain management strategy in interventional oncology and warrant consideration in clinical practice guidelines.

The Woodchuck Hepatitis Virus Model of Hepatocellular Carcinoma for Interventional Radiology Research.

Nanoparticles as Multifunctional Drug-Delivery Systems: A Comprehensive Review and Integration into Interventional Oncology.

The Oncopig Large Animal Cancer Model: Perspectives for Advancing Interventional Oncology.

Interventional oncology (IO) is a specialized field that focuses on using minimally invasive, image-guided procedures to support and treat patients with cancer. Oncology nursing has evolved from nurses providing care to also helping navigate the complexities of modern cancer treatment, such as IO. This article explores the evolution of IO, highlighting the role of oncology nurses and emphasizing the importance of specialized education to equip nurses with the necessary knowledge and skills to support patients undergoing IO procedures. The article reviews the advancements in IO procedures, including diagnosis, treatment, and supportive care, and assesses the impact of specialized education on nursing practice. Various educational strategies are discussed to enhance nurses' competencies in IO. Specialized education in IO helps nurses effectively support patients and improve outcomes, ultimately leading to better patient engagement and reduced anxiety. Interprofessional collaboration and continuous professional development aim to maintain high standards of care in the ever-evolving field of IO.

An interprofessional approach to patient care contributes to quality outcomes, aligned goals of care, and communication among teams. Interventional oncology (IO) is an innovative specialty that may combine multiple disciplines and requires effective communication and a team-based approach to deliver high-quality care. This article presents a leadership perspective on interprofessional collaboration in cancer care, specifically focusing on the importance of communication and a team-based approach for patient-centered care within IO programs. The author conducted a search using the CINAHL® Plus database. Keywords such as interventional oncology, interventional oncology nursing, and interventional oncology programs and associated themes, including multidisciplinary collaboration and tumor boards, were used to identify evidence within the IO specialty. Advancements in treatment provide patients with options to manage their disease among multiple disciplines. There is minimal to no evidence on IO programs and their impact on patient outcomes through interprofessional collaboration. Clinical IO care teams need to operate in an interprofessional framework to provide patient-centered care.

Interventional oncology (IO) has become a key oncology subspecialty, emphasizing patient-centered care (PCC) to prioritize individual patient needs, preferences, and values throughout treatment. In radiation oncology, PCC aims to enhance patient satisfaction and quality of life by tailoring treatments to individual needs. This article explores the implementation and outcomes of PCC in IO, and reviews case studies and research on PCC strategies, such as person-centered nursing, shared decision-making, and communication. PCC in IO improves patient satisfaction, emotional well-being, and quality of life. Effective communication, shared decision-making, and the involvement of patient care teams support these outcomes. However, challenges remain in uniformly applying PCC, with some studies having mixed results in patient experiences and hospital use, suggesting that additional tailored interventions are necessary for widespread implementation.

In the increasing population of patients with lung cancer, interventional pulmonology addresses airway emergencies, such as central airway obstruction caused by tumor growth and life-threatening hemoptysis. The purpose of these case studies was to understand the role of interventional pulmonology procedures, such as bronchial artery embolization and stent placement, in patients with lung cancer, as well as nurses' responsibility for ensuring patient quality of life and safety. This article provides descriptions based on case studies. It also provides information from the literature on interventional pulmonology and interventional oncology procedures along with the nurse's role, skills, and responsibilities. Integrating minimally invasive diagnostic and therapeutic interventions in oncology can enhance patient safety and improve quality of life throughout the cancer continuum. Procedures like airway stenting and bronchial artery embolization can relieve symptoms, reduce pain, and shorten hospital stays. Oncology nurses may be able to support accurate monitoring, early detection, and timely intervention to improve patient outcomes.

The opportunity has arrived for nursing pioneers to expand the scope of oncology nursing to align with innovative technologies and emerging therapies in cancer care, welcoming the future of interventional oncology nursing.

Abstract Purpose Interventional Oncology (IO) offers essential, minimally invasive treatment options for cancer patients, yet remains underrepresented in undergraduate medical education. The aim of this study was to assess medical students’ knowledge, awareness and perceptions of interventional radiology (IR), with a special focus on IO. Methods An anonymous online survey was distributed to 300 fifth-year medical students at a German medical school between winter 2023 and summer 2024. The questionnaire covered demographics, knowledge of IR procedures, IR’s clinical practice and interest in radiology as a career. Descriptive statistics were conducted. Results Eighty-five students (28.3% response rate) participated. Although all participants (100%) were aware of IR, only 36.5% had prior exposure during medical school. Most students (67.1%) rated their knowledge of IR as poor. Vascular procedures were largely recognized as part of IR, while knowledge of IO-specific procedures was low. Fewer than half correctly identified renal tumor ablation (48.8%), hepatic tumor ablation (43.5%) and lung biopsy (42.4%) as IR procedures. Regarding clinical practice, students assumed IR departments run outpatient clinics (69.0%), admit patients (65.5%) and do ward rounds (64.3%), whereas 41.7% thought IR departments have own inpatient beds. Although 70.6% expressed interest in IR, more than three-quarters (78.8%) rejected radiology as a career, citing lack of patient contact (57.6%) as the main reason. Conclusion Despite high general awareness, students showed limited understanding of IR’s clinical practice and poor knowledge of IO procedures. Early, structured integration of IO into undergraduate curricula is essential to improve awareness, break down misconceptions and attract future specialists.

Cost-Effectiveness Analysis (CEA) plays a crucial role in Health Technology Assessment (HTA) by informing healthcare decision-making on resource allocation. A rigorous CEA requires selecting appropriate comparators, assessing costs comprehensively, evaluating clinically relevant outcomes, and employing robust modeling techniques to determine an intervention's value for money. This is particularly relevant in interventional oncology, where innovative yet costly procedures must demonstrate long-term benefits to justify adoption. Economic evidence is essential to guide healthcare decision-making by balancing clinical effectiveness with the efficient use of resources. However, CEA findings must be interpreted within the broader HTA framework, incorporating ethical, organizational, and social considerations. Using the analysis by Rognoni et al. as a case study comparing transarterial radioembolization (TARE) and sorafenib for the treatment of liver tumors, this paper illustrates how CEA supports evidence-based healthcare policies.

Randomised controlled trials (RCTs) have traditionally been regarded as the gold standard in evidence-based medicine, providing a high level of evidence. However, mounting complexities, ranging from ethical issues and logistical barriers to rapid technological evolutions, have sparked interest in alternative or complementary evidence-generation methods. Real-world evidence (RWE) from large, well-designed research projects is increasingly viewed as powerful tools. Although RWE is sometimes perceived as "less robust" compared to RCTs due to potential biases, recent advances in study design, data capture, and analytical frameworks have highlighted its potential for shaping clinical practice and informing regulatory decisions. This article discusses the benefits and challenges of RWE within interventional oncology and explores whether it is merely "better than nothing" or indeed represents a key pillar of the future of clinical research.

PET-CT in the Management of Metastatic Neuroendocrine Tumors by Interventional Oncology.

BackgroundYttrium-90 (90Y) microsphere radioembolization has shown unique advantages in treating both primary and metastatic liver cancer and was introduced into China in 2022. Despite the development of various dosimetric models—ranging from empirical to voxel-based approaches—practical implementation remains challenging. With over 370,000 new liver cancer cases annually and limited access to certified 90Y treatment centers, Chinese interventional oncology departments face increasing pressure to balance dosimetric accuracy with clinical efficiency. This study aims to develop a GPU-based fast Monte Carlo project for accurate voxel-level dose calculation and to evaluate its performance alongside existing dosimetric strategies, with the goal of supporting optimized clinical workflows in high-volume settings.MethodsA fast Monte Carlo simulation algorithm was developed using Graphics Processing Unit (GPU) acceleration and applied retrospectively to eight patients diagnosed with hepatocellular carcinoma or metastatic colorectal cancer. The dosimetric performance of the GPU-based approach was compared against direct Monte Carlo (MC) simulations, the Medical Internal Radiation Dose (MIRD) formalism, the Voxel S-value (VSV) method, and the Local Energy Deposition (LED) model. Voxel- and organ-level dose accuracy were quantified using metrics such as Mean Absolute Relative Error (MARE), Relative Standard Deviation (RSD), and D95 in dose volume histogram. Statistical comparisons were conducted using Shapiro-Wilk normality tests and repeated measures ANOVA to assess inter-method differences.ResultsThe GPU-based Monte Carlo code demonstrated high accuracy and computational efficiency. Using direct MC simulation as the reference, the GPU-based approach yielded the lowest voxel-level variability, with median RSDs in high-activity transverse regions reaching − 1.13%, indicating superior consistency. Corresponding MARE were 4.53% for the GPU method, compared to 6.71% for VSV and 49.36% for LED, confirming its dosimetric reliability. At the organ level, the GPU-based method achieved RSDs of 0.35% ± 0.80% (tumor), -0.45% ± 0.76% (liver), 1.41% ± 4.45% (lung), and − 1.43% ± 1.23% (spleen), significantly outperforming alternative models. Notably, VSV and LED substantially underestimated lung dose (-52.19% ± 23.87%, -53.71 ± 22.17%), highlighting their limited applicability in heterogeneous regions. In contrast, the dose of spleen (F = 3.26, p = 0.069) and kidneys (F = 3.22, p = 0.071) did not show statistically significant differences between methods. In terms of computational performance, the GPU-based code delivered a remarkable 1,296-fold speed-up over traditional MC simulations, enabling efficient voxel-level dosimetry suitable for clinical workflows.ConclusionThe GPU-based fast Monte Carlo simulation provides a highly accurate and computationally efficient tool for voxel-level dosimetry in 90Y radioembolization. It enables precise estimation of tumor and lung doses with significantly reduced processing time and hardware demands, offering clear clinical advantages in minimizing radiation pneumonitis risk and supporting high-throughput workflows. Importantly, a stratified approach to dosimetric modeling—selecting simplified methods such as VSV or LED for small, well-contained lesions, and reserving GPU-based Monte Carlo for anatomically complex or heterogeneous cases—may optimize the balance between accuracy and efficiency. Future work will focus on large-scale validation and formalizing model selection criteria tailored to tumor morphology and treatment scope, with the aim of advancing personalized dosimetric planning in liver-directed therapies.Clinical trial numberNot applicable.

PET-Computed Tomography in the Management of Sarcoma by Interventional Oncology.

BackgroundAdvanced-stage hepatocellular carcinoma (HCC) with high tumour burden and portal vein tumour thrombus (PVTT) is usually associated with poor survival outcomes. Rapid tumour control usually benefits long-term outcomes, which could be hardly achieved by solely systematic targeted and immunotherapy in current guidelines. Hepatic arterial infusion chemotherapy (HAIC) is reported as an effective intervention for rapid decrease of tumour burden. In order to determine the role of HAIC in the comprehensive treatments, a target trial emulation study is conducted to compare the effectiveness and safety of HAIC in combination with lenvatinib and programmed death receptor-1 (PD-1) inhibitors (H+L+P) to that of lenvatinib and PD-1 inhibitors (L+P) in patients with advanced HCC exhibiting high tumour burden and PVTT.Methods and analysisThis target trial emulation study will be conducted at nationwide, multicentre CHANCE registries in China. We aim to include at least 228 patients with advanced-stage HCC with high tumour burden (up-to-seven criteria out) and PVTT who received L+P with or without HAIC as the first-line treatment between January 2021 and December 2023. The study design adheres to the framework of target trial emulation. To mitigate biases, a stabilised inverse probability of treatment weighting will be conducted. Overall survival is defined as the primary endpoint. Secondary endpoints consist of progression-free survival, objective response rate and adverse events.Ethics and disseminationOur study was approved by the Medical Research Ethics Committee of the First Hospital of China Medical University, and the study protocol was also approved by the institutional review boards of participating centres. The ethics committee waived informed consent because the study was retrospective. The findings of this study will be submitted for publication in peer-reviewed journals and will also be shared at multiple conferences on interventional radiology and oncology, ranging from local to international.Trial registration numberNCT06631326.

Retrospective clinical studies are critical in interventional oncology (IO), offering insights by analyzing existing data. They are cost-effective, time-efficient, and invaluable for exploring real-world treatment trends, long-term effects, and rare diseases. Retrospective studies provide critical support for hypothesis generation, post-marketing surveillance, and addressing ethically or logistically challenging questions unsuitable for prospective or randomized controlled trials (RCTs). To maximize their utility, retrospective studies must ensure robust data quality, clear objectives, advanced statistical methods, and transparency. Despite challenges like biases and limited causal inference, their ability to complement RCTs and other types of prospective trials help to close crucial gaps in evidence generation, which makes them indispensable for research in the rapidly evolving field of interventional oncology.

Integrative Application of Traditional Chinese Medicine in Interventional Oncology: A Comprehensive Review